Objective: To explore whether the deletion (D) allele of angiotensin-converting enzyme (ACE) is associated with the risk or severity of bronchopulmonary dysplasia (BPD) among very low birth weight (BW) infants. Study ...Objective: To explore whether the deletion (D) allele of angiotensin-converting enzyme (ACE) is associated with the risk or severity of bronchopulmonary dysplasia (BPD) among very low birth weight (BW) infants. Study design: Infants with a BW ≤1250 g were prospectively recruited. The D and I (insertion) alleles of ACE were determined using a polymerase chain reaction followed by restriction fragment length polymorphism analysis. Results: Infants with DDDI genotype of ACE had a (mean ±SD) birth weight (938 ±204 g vs 925 ±196 g) and gestational age (28 ±3 weeks vs 28 ±2 weeks), similar to infants with II genotype of ACE (P > .05). Infants with DDDI genotype of ACE were more likely to have BPD than infants with II genotype (47%vs 22%, P = .025). Among infants with BPD, ACE DDDI genotype was more common among infants with moderate or severe BPD compared with infants with mild BPD (74%vs 26%, P = .012). The number of D alleles of ACE correlated directly and positively with the severity of BPD (R = 0.23, P = .045). Conclusion: The D allele of ACE is associated with an increased risk and severity of BPD among preterm infants.展开更多
Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thou...Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis. Objective: To see if the amount of oxygen used during resuscitation at birth triggers events that lead to the subsequent lung injury and if a reduction in oxygen used leads to a reduction in lung injury. Method: The outcomes of newborn babies less than 31 weeks gestation who were resuscitated using either 50% or 100% oxygen were examined. Eight of the babies receiving 50% oxygen required an increase in their oxygen concentration. Evidence of pulmonary inflammation was determined by quantifying interleukin 6, 1 β , and 10 and tumour necrosis factor a in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay. Results: There were no significant differences in any of the cytokines studied in either of the groups. Death occurred in 5/26 (19% ) babies who received 100% oxygen and 4/26 (15% ) babies who received 50% oxygen. Survival without bronchopulmonary dysplasia at 36 weeks postmenstrual age occurred in 14/26 (54% ) and 13/26 (50% ). Conclusion: Reducing the oxygen to 50% at resuscitation did not influence either short or long term outcomes, but a small benefit could not be excluded. There was no increase in adverse clinical outcomes in babies who received 100% oxygen.展开更多
文摘Objective: To explore whether the deletion (D) allele of angiotensin-converting enzyme (ACE) is associated with the risk or severity of bronchopulmonary dysplasia (BPD) among very low birth weight (BW) infants. Study design: Infants with a BW ≤1250 g were prospectively recruited. The D and I (insertion) alleles of ACE were determined using a polymerase chain reaction followed by restriction fragment length polymorphism analysis. Results: Infants with DDDI genotype of ACE had a (mean ±SD) birth weight (938 ±204 g vs 925 ±196 g) and gestational age (28 ±3 weeks vs 28 ±2 weeks), similar to infants with II genotype of ACE (P > .05). Infants with DDDI genotype of ACE were more likely to have BPD than infants with II genotype (47%vs 22%, P = .025). Among infants with BPD, ACE DDDI genotype was more common among infants with moderate or severe BPD compared with infants with mild BPD (74%vs 26%, P = .012). The number of D alleles of ACE correlated directly and positively with the severity of BPD (R = 0.23, P = .045). Conclusion: The D allele of ACE is associated with an increased risk and severity of BPD among preterm infants.
文摘Background: Bronchopulmonary dysplasia is an inflammatory fibrotic condition produced as a consequence of injurious influences in the neonatal lung. Exposing the premature lung to high concentrations of oxygen is thought to play an important part in lung injury pathogenesis. Objective: To see if the amount of oxygen used during resuscitation at birth triggers events that lead to the subsequent lung injury and if a reduction in oxygen used leads to a reduction in lung injury. Method: The outcomes of newborn babies less than 31 weeks gestation who were resuscitated using either 50% or 100% oxygen were examined. Eight of the babies receiving 50% oxygen required an increase in their oxygen concentration. Evidence of pulmonary inflammation was determined by quantifying interleukin 6, 1 β , and 10 and tumour necrosis factor a in bronchoalveolar lavage fluid by enzyme linked immunosorbent assay. Results: There were no significant differences in any of the cytokines studied in either of the groups. Death occurred in 5/26 (19% ) babies who received 100% oxygen and 4/26 (15% ) babies who received 50% oxygen. Survival without bronchopulmonary dysplasia at 36 weeks postmenstrual age occurred in 14/26 (54% ) and 13/26 (50% ). Conclusion: Reducing the oxygen to 50% at resuscitation did not influence either short or long term outcomes, but a small benefit could not be excluded. There was no increase in adverse clinical outcomes in babies who received 100% oxygen.
